产前B族链球菌感染对母儿的影响

The Influence of Antenatal BGS Infection on Mother infant

目的 了解孕妇的Ｂ族链球菌（ＧＢＳ）带菌情况及对新生儿的影响。 方法 对１２０ 例产妇产前取阴道后穹窿分泌物，分娩后取胎盘子面分泌物及新生儿胃液分别检测ＧＢＳ，留脐血检测Ｃ反应蛋白、ＩｇＭ、ＩｇＧ 抗体，产后观察母婴情况并随访６ 周。 结果 产前母体ＧＢＳ带菌率１５－８％ ，胎盘带菌率１０ ％ ，新生儿带菌率３－３ ％ ，患病率０－８３ ％ 。ＧＢＳ阳性孕妇既往流产史多，胎膜早破、早产发生率较阴性者高（Ｐ＜ ０．０５） 。产时胎儿窘迫、羊水混浊及新生儿低体重、新生儿肺炎发生率虽比阴性者高，但无统计学意义。脐血Ｃ反应蛋白、ＩｇＭ、ＩｇＧ 无明显升高。 结论 为降低ＧＢＳ感染对围产期母儿的患病率，应对孕妇常规行ＧＢＳ筛检，阳性孕妇应给予预防性治疗并于产前复查，产时应对ＧＢＳ阳性孕妇及新生儿给予适当治疗以避免发生并发症。

Objective To study the carrier rate of group B streptococcus(GBS) in pregnant women and its influence on their newborns. Methods In 120 cases of pregnant women we detected GBS in vaginal fornix before delivery and in placenta as well as newborn's gastric discharge respectively,also CRP,IgM,IgG in umbilical blood after delivery.The follow up lasted up to 6 weeks pastpartum for all cases. Results The GBS carrier rates of mother,placenta and infant were 15.8%,10% and 3.3%respectively,while the infant morbidity was 0.83%.Most of GBS positive women had histories of abortion before this pregnancy,whose incidences of premature rupture of membrane and premature birth were all higher than those in the GBS negtive group ( P <0.05).It was also found that there were more fetal distress,meconium stained amniotic fluid,low birth weight and pneumonia of newborn in GBS positive group than in the GBS negtive group,however no statistically significant difference.The levels of CRP,IgM and IgG were all normal. Conclusion In order to reduce the perinatal morbidity from GBS infection,screening of GBS should be performed routinly in late gestation and it is necessary to give preventive treatment for the GBS positive mothers and infants so as to decrease complications.